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Obstetrics and Gynecology, Maternal-Fetal Medicine Subinternship (Minnesota)

Description

This subinternship is designed for the fourth year medical student seriously interested in pursuing a career in obstetrics and gynecology. This rotation should provide an experience comparable to a month of obstetric internship, during which the student will function as an intern under the supervision of the senior or chief resident and Maternal Fetal Medicine Consultant. This rotation provides an intense experience in high-risk obstetrics, but also provides exposure to prenatal ultrasound diagnostic and evaluation techniques. Much of the teaching will be one-on-one with the Consultant. The student will be responsible for making arrangements for his/her elective rotation with the Consultant; this arrangement should be made several months ahead of time to facilitate on-call scheduling.

Specific goals

  1. To learn to participate as an integral part of the high-risk obstetrical service.
  2. To refine history and physical examination skills.
  3. To formulate a detailed problem list and prioritize management.
  4. To learn cost-effective evaluation of obstetrical, medical and surgical problems during pregnancy.
  5. To learn the best management of problems encountered during pregnancy.
  6. To learn post-operative management of complicated post surgical obstetrical patients.
  7. To learn the development of an ongoing help plan for complicated obstetrical patients.

Activity outline

Clinical:

  • Understand the maternal and fetal implications, clinical course, management and complications of:
    • common endocrine disorders of pregnancy (diabetes and thyroid)
    • hypertensive disorders of pregnancy (essential, preeclampsia, collagen vascular disorders)
    • common infectious disorders of pregnancy
  • Participate in the evaluation of inpatient and outpatient high risk consultations with the attending physician.
  • Perform history and physical examinations, radiologic and laboratory review along with plan development and daily rounding on assigned patients admitted through to the Antepartum Obstetrical Service.
  • Discuss necessary treatment recommendations with senior or chief resident.
  • Review workups with the appropriate consultant and perform and document an appropriate history and physical on all assigned patients.
  • Document patient progress with daily notes to be done before morning rounds.
  • Review literature appropriate for the obstetrical, medical or surgical conditions of the patient.
  • Understand the normal anatomy that can be seen on routine obstetric ultrasound.
  • Understand the sonographic findings and implications of the more commonly noted fetal anomalies seen during an obstetric ultrasound.
  • Understand the sonographic markers used for evaluation of aneuploidy.
  • Acquire operative skills as an assistant on the Obstetrical team.
  • Be available to scrub on all procedures performed by the obstetrical team.
  • Review appropriate obstetrical pathology.
  • Learn obstetrical procedures for prenatal diagnosis, antepartum intervention and obstetrical delivery.
  • Follow post-operatively patients you surgically assisted.
  • Manage postoperative patient problems appropriately.
  • Round on the patients in the late afternoon or after surgery and follow-up on problems.
  • Participate in post-operative outpatient visits.

Miscellaneous:

  • Attend and participate in all obstetrical conferences and AM rounds.
  • Present cases and papers to peers for educational purposes.
  • Communicate with cross-coverage, appropriately "signing-out" patients.
  • Maintain good communication with the Consultant senior or chief residents, patients, and family members to discuss progress and problems.
  • The subintern will carry a service pager all days and nights on call.
  • All hospital orders will need to be co-signed by a senior resident on the service or resident on-call.
  • At all times maintain the highest standards of integrity, efficiency, and dependability as the acting surgical intern.
  • Perform procedures when possible, i.e. ABGs, NG tubes, central lines, intubation.
  • The subintern should wear a name tag at all times.
  • Absences should not be scheduled during the subinternship.

Method of evaluation

Students will be assessed with formative verbal feedback halfway through the rotation, and summative feedback/evaluation, verbal and written, at the end. The course director, Dr. Brian Brost, will collate the written evaluations and provide a summary for the student.

  • ART286732